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Health Benefits Advisor for Employers

Determining Compliance with the Newborns' Act Provisions in Part 7 of ERISA

Where is the coverage?

If the plan provides benefits for hospital stays in connection with childbirth, the plan is insured, and the coverage is in Wisconsin and several U.S. territories, it appears that the Federal Newborns' Act applies to the plan.

If the plan provides benefits for hospital stays in connection with childbirth and is insured, whether the plan is subject to the Newborns' Act depends on State law. Based on a recent preliminary review of State laws, if the coverage is in any other state or the District of Columbia, it appears that State law applies in lieu of the Federal Newborns' Act.

For those plans with coverage that is insured by an insurance company or HMO, contact your State insurance department for the most current information on the State laws that pertain to hospital length of stay in connection with childbirth.